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July 27, 2017

ACO roundup: CMS mulls new behavioral health payment model

Daily Briefing
    • CMS announces meeting to discuss new behavioral health payment model. CMS last week announced its Center for Medicare & Medicaid Innovation will hold a public meeting on Sept. 8 to discuss ideas for a new payment model for behavioral health services. In a notice, CMS said it is considering the new payment model as a way to improve access, quality, and cost of care for Medicare, Medicaid, and CHIP beneficiaries with behavioral health conditions. CMS said the meeting will be open to the public, and the agency invited caregivers, community health organizations, health care providers, patient advocacy groups, state Medicaid officials, and other interested entities to attend.

    • Hospitals with more satisfied patients really do provide better care, research finds. A new working paper from the National Bureau of Economic Research suggests that hospitals with higher patient satisfaction scores might provide better care, Austin Frakt writes for the New York Times' "The Upshot." According to Joseph Doyle, an economist at the Massachusetts Institute of Technology and a co-author of the research, the paper found that "hospitals with more satisfied patients have lower mortality rates, as well as lower readmission rates"—indicating that "hospitals' patient satisfaction scores are useful signals of quality."

    • CMS to seek more authority to review MA plans' network adequacy. CMS is collecting comments on a new proposal that would give the agency greater authority to evaluate the adequacy of Medicare Advantage (MA) plans' provider networks. Currently, CMS can only assess plans' provider networks if a triggering event occurs, such as when a plan begins providing coverage under MA, when it starts offering coverage in a new region, or if a complaint is filed regarding the plan's network adequacy—and even in those instances, Modern Healthcare's Virgil Dickson reports, the agency sometimes can only conduct a partial review of the network. Under the proposed plan, MA plans would have to submit their networks to a federal database for review if their networks hadn't been comprehensively reviewed by the agency in the past 12 months. CMS is collecting comments on the proposal through Aug. 18.

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    • Is your Medicare risk strategy MACRA-ready? While the GOP's health reform effort continues to evolve, Medicare payment reform has quietly marched on with bipartisan support. And with MACRA well underway, the new administration has shown no signs of reversing course. As a result, hospital and health system leaders need to develop an intentional Medicare risk strategy. Check out our new research report to learn how to navigate the Medicare ACO programs, expand into the Medicare Advantage market, and ensure the longevity of your Medicare risk strategy by actively cultivating contracts over time.

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